Would you favor starting with pembrolizumab or chemotherapy for a metastatic MSI-high pancreatic ductal adenocarcinoma?

This is a great question. MSI-H status in PDAC is rare, about 1-2% of all PDAC (Luchini et al., PMID 32350089). Marabelle and colleagues published one of the initial studies using pembrolizumab in MSI-H solid tumors showing a response rate of 18.2% among PDAC (22 patients) with a median duration of ...